FEATURES OF BLOOD PRESSURE DAILY PROFILE IN HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES

Objective: To study the blood pressure daily profile in patients with hypertension (HNT) depending on the presence of type 2 diabetes mellitus (DM2). Design and method: We observed 412 hypertensive patients. The ambulatory BP monitoring (ABPM) was recorded with Medicom-combi device (Russia) using the oscillometric method. Statistical analysis was performed using the SPSS 24.0 software package. Results: Patients were divided into 2 groups: the first group consisted of hypertensive patients with DM2 (n = 121), and the second group consisted of hypertensive patients without DM2 (n = 291). Groups were comparable in office SBP: 133.7±20.19 mm Hg and 134.42±19.74 mm Hg, respectively. However, DBP was significantly higher in patients with DM2: 84.08±10.89 mmHg vs. 82.96±9.34 mmHg, p=0.02. Analysis showed that patients with DM2 had significantly higher average daily SBP (122.89± 13.38 vs. 119.467± 14.02 mmHg, respectively, p = 0.023) and DBP (71.401± 9.4 vs. 70.47± 7.40 mmHg, respectively, p = 0.021) compared to patients without DM2. Mean daily SBP (124.26±13.46 vs. 121.4±12.72 mmHg, respectively, p = 0.046) and mean daily DBP (29.19±25.76 vs. 24.11±27.22 mmHg, respectively, p = 0.012) were also higher in patients with DM2. SBP and DBP variability didn’t differ between the groups. Moreover, the load index of SBP in the daytime and nighttime was higher in the second group. Load index of daytime SBP –19.00±25.15% vs 12.89±19.49%, respectively, p=0.009 and load index of nighttime SBP - 35.03±34.78%–vs 24.71±30.08%, respectively, p=0.003. Nocturnal fall of SBP was deficient in-group with DM2 in comparison with one without DM2: nocturnal fall of SBP was 3.72±6.44% vs. 6.17±10.62%, p = 0.019, but nocturnal fall of DBP did not differ: 5.10±8.33% vs. 6.72±8.21%, respectively, p = 0.069. Dipping status was significantly lower in patients with DM2 (9.6 ±5.7%, x2 = 8.91, p = 0.03). The number of non-dippers (63.5% vs. 55%) and night-pickers (26.3% vs. 16.8%) was also higher in the second group without statistical significance. The number of over-dippers in both groups didn’t differ. Conclusions: Hypertensive patients with DM2 have more disturbances in the daily BP profile, which contribute to an increased risk of developing cardiovascular complications.

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